2185 Cool Stream Cir
Use BLUE or BLACK Ink
r
For Office Use
Permit#: v3 2
u( j
City of EaRd
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I S
I~
2012 RESIDENTIAL BUILDING PERMIT APPLICATION V
V
Date: ` 7013 Site Address: P-/ Fs- (jd L S- re-4 G rcfe EA( Unit
Name: J U leely ty e L ~ ~J Phone:yk3 'c7"l 9-1
RESIDENT /
OWNER Address/ City/ Zip: ZiG 0 S C o a L ~rp l.-.i r-c- le-
-t- ' p-V (E 1,L1-e14VCK-
Applicant is: X_ Owner Contractor C~ww~ rtc J y w - 61 V 3
TYPE OF WORK Description of work: _ic/oWSk @At mT- hwer 'e ye L w As &-t*°~x-yn-
Construction Cost: Multi-Family Building: (Yes / No )
Company: Contact:
CONTRACTOR Address: City:
State: Zip: Phone:
License Lead Certificate M
If the project is exempt from lead certification, please explain why: (see Page 3 for dditional information)
D 11°1 ~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.popherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
~ a.
_.i 01 {'P f]
x x
Applicant's Printed Name A p cant's Signature
L./ Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES 2 Cot> I
Foundation _ Fireplace Porch (3-Season) _ Storm Damage
Single Family _ Garage Porch (4-Season) _ Exterior Alteration (Single Family)
Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
Lower Level Pool Miscellaneous
Accessory Building
WORK TYPES
New _ Interior Improvement Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100%JZ) Zoning D_ City Water
Census Code H ly Stories Booster Pump
# of Units J Square Feet PRV
# of Buildings Length In Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation -de HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEE lbQ
Base Fee /G Z y0 ` /
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
-)Abs- -Ilse LEE or LACK laic
r---
I For Office Use
a.1g'1, a.1$~ Cool S~'reaxh. I ~ 3 (Qo I
rp r_,;.
-I
City of I Permit
a, Eatinn .~s
b I Permit Fee. 5-1 3830 Pilot Knob Road I I /
Eagan MN 55122 I I
I Date Received: I
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff: I
I
-----------------I
2013 COMMERCIAL BUILDING PERMIT APPLICATION
')N q 2 J e
Date: { Site Address: 4-1 T~ ! w C r I
Tenant Name: (Tenant is: New / Existing) Suite
Former Tenant:
Name: Phone:
Property Owner Address /City /Zip:
Applicant is: Owner Contractor
Type of mvork Description of work: tom(, C
Construction Cost: _37, (Q_L
;Name: License
Contractor Address. - ° City:
State: Zip: Phone:
Contact: _ Email: -
Name: Registration
Arch itect/Enineer 'Address: City:
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone
NOTE: plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.,qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name Ai3pff nt's Signature
Page 1 of 3